Published online Dec 6, 2019. doi: 10.12998/wjcc.v7.i23.3990
Peer-review started: September 27, 2019
First decision: October 24, 2019
Revised: October 31, 2019
Accepted: November 15, 2019
Article in press: November 15, 2019
Published online: December 6, 2019
Processing time: 69 Days and 19.4 Hours
Although it has been shown that arylsulfatases are lost in colorectal cancer (CRC) cell lines, their exact role in the carcinogenesis and behavior of this cancer was not elucidated. No data about the correlation between serum and immunohistochemical (IHC) level of arylsulfatases (ARSA, ARSB) in patients with CRC were published yet.
To evaluate the possible prognostic value of ARSA and/or ARSB in CRC, at circulating and protein levels.
The present study included 45 consecutive patients who were prospectively diagnosed with CRC. For IHC stains (protein expression) ARSA, ARSB and maspin expression were quantified. For these markers, cytoplasmic expression was taken into account. For gene expression study, circulating mRNA was isolated from all patients, before surgery. A group of 45 healthy patients without inflammatory or tumor pathologies was used as control group. Reverse transcription and Taqman Gene Expression Array were used for ARSB gene expression.
The preoperative circulating RNA level of the ARSB gene was significantly decreased in patients with CRC (RQ < 1), compared with the control group (RQ > 1). A more significant decrease (RQ < 0.5) occurred in ulcero-infiltrative maspin-positive adenocarcinomas, with a higher degree of tumor budding, diagnosed in locally advanced stages (pT3/4). ARSA/maspin immunopositivity indicated a higher risk for lymph node metastasis, while triple positivity for maspin/ARSA/ARSB and ARSB gene expression level < 0.5 were indicators of CRC aggressive behavior, independent of lymph node status.
The significant independent negative prognostic factors of CRC are the ulcero-infiltrative aspect, high budding degree, triple positivity for maspin, ARSA and ARSB, and low ARSB gene expression.
Core tip: In this paper we tried to emphasize the role of arylsulfatases (ARSA, ARSB) in colorectal cancer (CRC) beahaviour and possible role of ARSB serum level in follow-up of patients. This is the first study in literature which proved that a low ARSB gene expression in serum (RQ < 1) might be a non-invasive indicator of risk of CRC. Moreover, triple positivity for maspin/ARSA/ARSB and ARSB gene expression level < 0.5 were proved to be indicators of CRC aggressive behavior, independent of lymph node status.